Healthy Aging: The 30s -- And Baby Makes Three
As women age, they must take extra care to ensure a healthy pregnancy
TUESDAY, Dec. 27 (HealthDay News) -- In 1970, the average American woman was 21.4 years old when she gave birth to her first child. By 2000, that figure had climbed to 25, according to federal statistics.
The increase in age reflects the fact that many couples today are postponing childrearing until their 30s and 40s.
But as women age, they must take extra care to ensure a healthy pregnancy, experts say.
"That means, first and foremost, getting proper prenatal care," said Dr. Thomas Weida, a spokesman for the American Academy of Family Physicians.
"In some cases, experts are even advocating a preconception visit -- either to the family doctor or an ob-gyn, to look for any risk factors that might complicate pregnancy, things like smoking, drinking, drug use," he said. Every woman knows -- or should know -- that drinking, smoking and pregnancy don't mix, but studies show that a significant percentage of women still ignore these warnings.
Fertility in women begins a gradual decline in the mid-30s, Weida said, while men's fertility remains stable until much later in life. Once conception has occurred, regular visits to the doctor can reassure moms- and dads-to-be that all's well.
"There's regular ultrasound, of course, as well as tests for certain genetic defects," said Weida, who is also a professor of family and community medicine at Pennsylvania State College of Medicine in Hershey. "As women get older -- say, from 35 into their 40s -- you also have the possibility of doing amniocentesis to look for defects."
Weida always advises women to take a multivitamin during their pregnancy, as well as folic acid, which protects against severe neural tube defects such as spina bifida.
Then there's delivery. The most common, serious complication is preeclampsia, where the mother's blood pressure suddenly soars. "It's tough to predict this, because you can get preeclampsia and be of average weight and never have had high blood pressure," Weida said. "Certainly though, if you do have medical problems such as diabetes, that puts you at slightly higher risk. Those things are usually looked for during prenatal visits," he said.
A healthy delivery means a newborn needing lots of nourishment to grow. "Experts now agree that breast-feeding is the 'formula' of choice," Weida said, with hundreds of studies confirming breast milk's power in speeding development and boosting infant immune systems. "During this period, moms obviously need to hydrate themselves and keep up their nutrition," he added. "So, sometimes I'll continue vitamin supplements after delivery, too."
New moms and those who love them also need to be on the lookout for postpartum depression. "It's all about duration and intensity," Weida said. Short-term "blues" shouldn't be of great concern, "but severe depression that goes on for a couple weeks -- that's certainly an issue that needs to be looked at," he said.
And what about Dad? According to Weida, his role in this family drama is basically as key supporting player -- with Mom and Baby the stars. "As most new fathers know, this means a lot of getting up at night," he said.
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
Wednesday, January 18, 2006
Friday, January 13, 2006
Britney Spears Give Birth to a Baby Boy
THURSDAY, Sept. 15 (CNN) -- The singer underwent a caesarean at Santa Monica's UCLA Medical Center, near Los Angeles, according to the magazine US Weekly and television show "Access Hollywood."
Britney, 23, and her husband Kevin Federline announced the pregnancy in April.
Reports suggest that they will call the baby either London Preston or Preston Michael. Her top name for a girl was Addison Shye.
It is the first child for Britney, while Kevin, 27, has two young children -- Kori, three, and one-year-old Kaleb -- with ex-girlfriend, Shar Jackson.
Last month, the singer revealed: "I have a feeling I'm going to have an operation. I don't know why but I hope so.
"My mom said giving birth was the most excruciating thing she's ever gone through in her life. So if a caesarian doesn't happen, I'll be like, 'Epidural, please.' "
The star, who has sold more than 60 million albums, has made no secret of her wish to start a family and has said she can see herself as a mother.
Shortly after tying the knot in a private ceremony last September, she announced she would be taking a break from music to enjoy married life and focus on motherhood.
"I've had a career since I was 16, have traveled around the world and back and even kissed Madonna," she wrote on her Web site.
"The only thing I haven't done so far is experience the closest thing to God and that's having a baby. I can't wait."
Britney hosted a Moroccan-themed baby shower at her Malibu home last month.
Presents included a white wrought-iron bassinet from her mother, Lynne, a car seat, a stroller, an infant bathtub and lots of stuffed animals.
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
Wednesday, December 21, 2005
Health Tip: Preparing For Your Pregnancy
(HealthDay News) -- Women can take many precautions to promote a health pregnancy before they become pregnant.
Here's a list of pre-pregnancy planning tips, courtesy of the Palo Alto Medical Foundation:
Here's a list of pre-pregnancy planning tips, courtesy of the Palo Alto Medical Foundation:
- Stop smoking to reduce the risk of a low birth weight baby, a miscarriage or a stillbirth.
- Avoid drinking alcohol.
- Talk to your doctor about how prescription medications may affect your pregnancy. Some of these medications include the birth control pill, Accutane, and seizure and cancer medications.
- Take a multivitamin with at least 400 micrograms of folic acid each day.
- Maintain good health by eating healthy, exercising and maintaining a healthy weight.
SIDS Linked to Subsequent Preemie Births
FRIDAY, Dec. 16 (HealthDay News) -- Women who've suffered the death of a baby due to sudden infant death syndrome (SIDS) are at increased risk of premature delivery and complications in subsequent pregnancies, British researchers report.
Writing in this week's issue of The Lancet, they noted these complications are also risk factors for SIDS. The finding may explain why some women have a family history of recurrent SIDS.
The University of Cambridge researchers analyzed data collected from more than 258,000 women who had consecutive births in Scotland between 1995 and 2001.
They found that women whose previous infant died were two to three times more likely than other women to have a premature baby, and two to three times more likely to deliver a small baby.
The study also found that women who had a premature delivery or a small baby had a twofold increased risk of SIDS occurring in infants they had in subsequent years. The association held true even after the researchers factored in other possible SIDS risk factors such as smoking, age and marital status.
"Our findings suggest a mechanism that would predispose women to recurrent cases of SIDS, and provide direct evidence that the risk of SIDS after a given birth is not statistically independent of whether the previous infants died," the study authors noted.
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
Writing in this week's issue of The Lancet, they noted these complications are also risk factors for SIDS. The finding may explain why some women have a family history of recurrent SIDS.
The University of Cambridge researchers analyzed data collected from more than 258,000 women who had consecutive births in Scotland between 1995 and 2001.
They found that women whose previous infant died were two to three times more likely than other women to have a premature baby, and two to three times more likely to deliver a small baby.
The study also found that women who had a premature delivery or a small baby had a twofold increased risk of SIDS occurring in infants they had in subsequent years. The association held true even after the researchers factored in other possible SIDS risk factors such as smoking, age and marital status.
"Our findings suggest a mechanism that would predispose women to recurrent cases of SIDS, and provide direct evidence that the risk of SIDS after a given birth is not statistically independent of whether the previous infants died," the study authors noted.
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
It's (Often) a Boy! -- If Conception Takes Longer
THURSDAY, Dec. 15 (HealthDay News) -- The longer a woman takes to get pregnant, the more likely she is to have a baby boy.
That's the conclusion of a new Dutch study that appears in the Dec. 17 issue of the British Medical Journal.
Researchers analyzed data on 5,283 women who gave birth to single babies over a two-year period. They found that the 498 women who took longer than 12 months to conceive had a 58 percent chance of having a baby boy, compared with 51 percent for women who took less time to get pregnant.
For couples who conceive naturally, each additional year of trying to get pregnant is associated with a nearly 4 percent greater expected probability of having a baby boy, the study authors calculated. This was true even after the researchers adjusted for factors such as age, smoking status, alcohol use and menstrual cycle variability.
The study found no relation between a baby's gender and length of time getting pregnant among couples who had medical help in conceiving.
The researchers said their findings support the idea that sperm bearing the Y (male) chromosome swim faster in viscous fluids than sperm bearing the X (female) chromosome. They said women who have relatively viscous cervical mucous would have more difficulty getting pregnant and would be more likely to have a male baby if they do get pregnant.
The study may also explain why more boys than girls are born worldwide (105 boys to 100 girls in most countries), even though human semen contains equal amounts of X and Y bearing sperm, the researchers at Maastricht University said.
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
That's the conclusion of a new Dutch study that appears in the Dec. 17 issue of the British Medical Journal.
Researchers analyzed data on 5,283 women who gave birth to single babies over a two-year period. They found that the 498 women who took longer than 12 months to conceive had a 58 percent chance of having a baby boy, compared with 51 percent for women who took less time to get pregnant.
For couples who conceive naturally, each additional year of trying to get pregnant is associated with a nearly 4 percent greater expected probability of having a baby boy, the study authors calculated. This was true even after the researchers adjusted for factors such as age, smoking status, alcohol use and menstrual cycle variability.
The study found no relation between a baby's gender and length of time getting pregnant among couples who had medical help in conceiving.
The researchers said their findings support the idea that sperm bearing the Y (male) chromosome swim faster in viscous fluids than sperm bearing the X (female) chromosome. They said women who have relatively viscous cervical mucous would have more difficulty getting pregnant and would be more likely to have a male baby if they do get pregnant.
The study may also explain why more boys than girls are born worldwide (105 boys to 100 girls in most countries), even though human semen contains equal amounts of X and Y bearing sperm, the researchers at Maastricht University said.
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
Male Preemie Babies at Higher Risk for Hypertension As Adults
MONDAY, Nov. 21 (HealthDay News) -- Male infants born prematurely are at increased risk of developing high blood pressure decades later, Swedish researchers report.
The reasons for this rise in risk are unclear; however, the researchers don't think it can be explained by family history or genetics. Rather, they believe environmental challenges linked to prematurity may explain an increased risk for high blood pressure later in adulthood.
"Preterm-born men have an increased risk of high blood pressure and the risk is inversely proportional to the degree of prematurity -- the more premature, the higher the risk," noted lead author Dr. Stefan Johansson, a neonatologist at Karolinska University Hospital in Stockholm.
The study only included male babies -- experts note that a similar study in females might turn up similar trends.
The report appears in the November 29 edition of Circulation: Journal of the American Heart Association.
In their study, Johansson's team collected blood pressure and birth data on nearly 330,000 Swedish men born between 1973 and 1981.
They found that, compared with males born full-term, males who were born extremely preterm -- less than 29 weeks -- have almost twice the risk of developing high systolic blood pressure in adulthood. Systolic pressure refers to the first number in a blood pressure reading.
In addition, those who were very preterm -- 29 to 32 weeks -- had a 45 percent increased risk of high systolic blood pressure, while those born moderately pre-term -- 33 to 36 weeks -- had a 24 percent higher risk.
"The risk associated with preterm birth is most probably not explained by familial factors," Johansson said. "Our study further supports the concept that diseases in adulthood are associated with very early exposures [to environmental challenges]," he added.
Johansson thinks more research is needed on why preterm birth is associated with this risk of high blood pressure and recommends intervention as early as possible. "I think that clinical follow-up programs of children born more than three months before term should include blood pressure checks during their visits," he advised.
Another expert pointed out that these findings were confined to males only.
"At the present time, the study cannot be extrapolated to women born preterm because only men were included in this study," said Dr. Nieca Goldberg M.D., chief, Cardiac Rehabilitation and Prevention Center, Lenox Hill Hospital, and assistant clinical professor, medicine, New York University School of Medicine, in New York City.
"Other studies should be done to see if this relationship can be applied to women and people of various racial and ethnic backgrounds," she said. "Work like this will help us to identify risk factors earlier in life and apply preventive strategies that will ultimately reduce risk of heart disease and stroke."
Another expert said the study may shed more light on the causes of high blood pressure.
"This is a very interesting study," said Dr. Roger S. Blumenthal, an associate professor of medicine and director of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease in Baltimore. "It shows that what happens to us when we are born can affect the development of high blood pressure 40 plus years later, which is quite fascinating. This may help to shed light on some of the other causes of high blood pressure."
Blumenthal adds that knowing this makes it even more important to make the lifestyle changes that help fight high blood pressure.
"People need to remember that the best way to prevent or control hypertension and type 2 diabetes is to exercise more and follow better dietary habits," he noted. "For now, that should be the focus of our efforts in America and elsewhere."
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
The reasons for this rise in risk are unclear; however, the researchers don't think it can be explained by family history or genetics. Rather, they believe environmental challenges linked to prematurity may explain an increased risk for high blood pressure later in adulthood.
"Preterm-born men have an increased risk of high blood pressure and the risk is inversely proportional to the degree of prematurity -- the more premature, the higher the risk," noted lead author Dr. Stefan Johansson, a neonatologist at Karolinska University Hospital in Stockholm.
The study only included male babies -- experts note that a similar study in females might turn up similar trends.
The report appears in the November 29 edition of Circulation: Journal of the American Heart Association.
In their study, Johansson's team collected blood pressure and birth data on nearly 330,000 Swedish men born between 1973 and 1981.
They found that, compared with males born full-term, males who were born extremely preterm -- less than 29 weeks -- have almost twice the risk of developing high systolic blood pressure in adulthood. Systolic pressure refers to the first number in a blood pressure reading.
In addition, those who were very preterm -- 29 to 32 weeks -- had a 45 percent increased risk of high systolic blood pressure, while those born moderately pre-term -- 33 to 36 weeks -- had a 24 percent higher risk.
"The risk associated with preterm birth is most probably not explained by familial factors," Johansson said. "Our study further supports the concept that diseases in adulthood are associated with very early exposures [to environmental challenges]," he added.
Johansson thinks more research is needed on why preterm birth is associated with this risk of high blood pressure and recommends intervention as early as possible. "I think that clinical follow-up programs of children born more than three months before term should include blood pressure checks during their visits," he advised.
Another expert pointed out that these findings were confined to males only.
"At the present time, the study cannot be extrapolated to women born preterm because only men were included in this study," said Dr. Nieca Goldberg M.D., chief, Cardiac Rehabilitation and Prevention Center, Lenox Hill Hospital, and assistant clinical professor, medicine, New York University School of Medicine, in New York City.
"Other studies should be done to see if this relationship can be applied to women and people of various racial and ethnic backgrounds," she said. "Work like this will help us to identify risk factors earlier in life and apply preventive strategies that will ultimately reduce risk of heart disease and stroke."
Another expert said the study may shed more light on the causes of high blood pressure.
"This is a very interesting study," said Dr. Roger S. Blumenthal, an associate professor of medicine and director of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease in Baltimore. "It shows that what happens to us when we are born can affect the development of high blood pressure 40 plus years later, which is quite fascinating. This may help to shed light on some of the other causes of high blood pressure."
Blumenthal adds that knowing this makes it even more important to make the lifestyle changes that help fight high blood pressure.
"People need to remember that the best way to prevent or control hypertension and type 2 diabetes is to exercise more and follow better dietary habits," he noted. "For now, that should be the focus of our efforts in America and elsewhere."
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
Preterm Birth: The Nation's Leading Killer of Newborns
FRIDAY, Nov. 18 (HealthDay News) -- Stephanie Smith, a 41-year-old New Yorker, was a model mother-to-be when she became pregnant three years ago.
A dancer and massage therapist, she'd always been extremely fit and health conscious and was diligent in her pre-natal care.
So she was stunned when her son, Max, was born premature at 29 weeks and six days and weighed 2 pounds, 13 ounces.
"I was shocked. I never expected to go into premature labor," Smith said. "I did everything right."
Normal gestation is approximately 40 weeks, and a birth before 37 weeks is considered premature.
Max, now 3, was born with multiple health problems as a result of his prematurity. And Stephanie and her husband, Bernie Yee, struggled to take care of him through months of at-home care that initially included oxygen supplementation and tube feeding, a re-hospitalization for respiratory distress and a collapsed lung, with an induced coma needed to stabilize him.
"Everything that saved his life also caused other problems," Smith said.
Now Max is in school, and Smith is pleased with his progress, but noted that he lags behind other children his age in stamina.
Smith spoke Tuesday St. Mary's Healthcare System for Children in Queens, N.Y., a stop on a March of Dimes tour throughout New York City to highlight Prematurity Awareness Month.
March of Dimes President Dr. Jennifer L. Howse said Max's problems highlight the importance of focusing attention on the debilitating and often ongoing problems resulting from premature delivery, the cause of which is largely unknown.
On Tuesday, the U.S. Centers for Disease Control and Prevention reported that the number of preterm births increased by 2 percent from 2003 to 2004. More than 500,000 babies were born before 37 weeks of gestation in 2004, and there has been an 18 percent increase in preterm births since 1990, the agency said.
"We are so saddened by the increase because it means that more babies are going to have to struggle and more families will have a lifetime of health consequences to deal with," Howse said.
The CDC report was released on the third annual Prematurity Awareness Day, which the March of Dimes hopes will serve as a springboard for passing federal legislation to coordinate efforts on finding the causes for premature births and decreasing their numbers, the nation's leading killer of newborns.
According to Howse, there's no known cause for approximately half of the nation's preterm births.
"A mom can do everything right -- nutrition, diet, exercise and have no previous history of prematurity," Howse said, and still deliver a baby too soon.
Known reasons for preterm births include obesity; a lack of pre-conception and pre-natal care, which is common among women with no health insurance; and the use of fertility drugs, she said.
Howse said that twins have a 50 percent greater chance of being born prematurely, and that triplets and higher numbers of babies born together have a 90 percent chance of a too-early birth that brings high risks of often severe health problems. Those problems include neurological, learning, hearing and vision problems and cerebral palsy.
When women take fertility drugs, Howse said, it's very important that they get good medical advice. Often with assisted-reproduction technology, women will have four or five eggs implanted, raising the risk of multiple births, she said.
"It's a delicate area," Howse said, because a woman wants to have a baby, and if her doctor advises her that more eggs will increase the likelihood of success, she might do that without understanding the medical risks of premature delivery.
Another issue is that technology has enabled doctors to save the lives of ever-younger premature babies, resulting in more complex medical problems facing these infants and the doctors who treat them. St. Mary's offers long-term care for the continuing health problems of premature babies as they grow. Smith's son has been treated there.
"We've never had such tiny babies," said St. Mary's president Dr. Burton Grebin, who reported that the hospital's preterm baby population has doubled since its nursery opened in 1984.
"We have seen a dramatic impact because we have to adapt with increased technology, new equipment and more staffing. Some of these problems are subtle and go on for years," he said.
Howse said the federal government presently has no concerted plan to address the problems of premature births. She urged passage of a bill now before Congress that would create a federal agenda to research prematurity.
"We need to raise public awareness and gain the political will to focus on this problem," she said.
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
A dancer and massage therapist, she'd always been extremely fit and health conscious and was diligent in her pre-natal care.
So she was stunned when her son, Max, was born premature at 29 weeks and six days and weighed 2 pounds, 13 ounces.
"I was shocked. I never expected to go into premature labor," Smith said. "I did everything right."
Normal gestation is approximately 40 weeks, and a birth before 37 weeks is considered premature.
Max, now 3, was born with multiple health problems as a result of his prematurity. And Stephanie and her husband, Bernie Yee, struggled to take care of him through months of at-home care that initially included oxygen supplementation and tube feeding, a re-hospitalization for respiratory distress and a collapsed lung, with an induced coma needed to stabilize him.
"Everything that saved his life also caused other problems," Smith said.
Now Max is in school, and Smith is pleased with his progress, but noted that he lags behind other children his age in stamina.
Smith spoke Tuesday St. Mary's Healthcare System for Children in Queens, N.Y., a stop on a March of Dimes tour throughout New York City to highlight Prematurity Awareness Month.
March of Dimes President Dr. Jennifer L. Howse said Max's problems highlight the importance of focusing attention on the debilitating and often ongoing problems resulting from premature delivery, the cause of which is largely unknown.
On Tuesday, the U.S. Centers for Disease Control and Prevention reported that the number of preterm births increased by 2 percent from 2003 to 2004. More than 500,000 babies were born before 37 weeks of gestation in 2004, and there has been an 18 percent increase in preterm births since 1990, the agency said.
"We are so saddened by the increase because it means that more babies are going to have to struggle and more families will have a lifetime of health consequences to deal with," Howse said.
The CDC report was released on the third annual Prematurity Awareness Day, which the March of Dimes hopes will serve as a springboard for passing federal legislation to coordinate efforts on finding the causes for premature births and decreasing their numbers, the nation's leading killer of newborns.
According to Howse, there's no known cause for approximately half of the nation's preterm births.
"A mom can do everything right -- nutrition, diet, exercise and have no previous history of prematurity," Howse said, and still deliver a baby too soon.
Known reasons for preterm births include obesity; a lack of pre-conception and pre-natal care, which is common among women with no health insurance; and the use of fertility drugs, she said.
Howse said that twins have a 50 percent greater chance of being born prematurely, and that triplets and higher numbers of babies born together have a 90 percent chance of a too-early birth that brings high risks of often severe health problems. Those problems include neurological, learning, hearing and vision problems and cerebral palsy.
When women take fertility drugs, Howse said, it's very important that they get good medical advice. Often with assisted-reproduction technology, women will have four or five eggs implanted, raising the risk of multiple births, she said.
"It's a delicate area," Howse said, because a woman wants to have a baby, and if her doctor advises her that more eggs will increase the likelihood of success, she might do that without understanding the medical risks of premature delivery.
Another issue is that technology has enabled doctors to save the lives of ever-younger premature babies, resulting in more complex medical problems facing these infants and the doctors who treat them. St. Mary's offers long-term care for the continuing health problems of premature babies as they grow. Smith's son has been treated there.
"We've never had such tiny babies," said St. Mary's president Dr. Burton Grebin, who reported that the hospital's preterm baby population has doubled since its nursery opened in 1984.
"We have seen a dramatic impact because we have to adapt with increased technology, new equipment and more staffing. Some of these problems are subtle and go on for years," he said.
Howse said the federal government presently has no concerted plan to address the problems of premature births. She urged passage of a bill now before Congress that would create a federal agenda to research prematurity.
"We need to raise public awareness and gain the political will to focus on this problem," she said.
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
Placenta Problems Predict Early Heart Trouble
THURSDAY, Nov. 17 (HealthDay News) -- Pregnant women with abnormal placentas appear to be at a twofold risk of developing early cardiovascular disease compared to women without these problems, Canadian researchers report.
Maternal placental syndromes include preeclampsia (high blood pressure during pregnancy) and conditions where the placental blood vessels become blocked. These include placental abruption and placental infarction, where the placenta becomes detached from the wall of the uterus.
Risk factors for placental syndromes include obesity, insulin resistance, high blood pressure and high cholesterol. These same conditions are also independent risk factors for cardiovascular disease.
"We looked at more than 1 million women who delivered," said study author Dr. Joel G. Ray, an assistant professor of obstetrics and gynecology at St. Michael's Hospital of the University of Toronto. "We examined whether they experienced a problem with their placenta or not."
In the CHAMPS (Cardiovascular Health After Maternal Placental Syndromes) study, Ray and his colleagues found that of the 1.03 million women in the study, 75,380 were diagnosed with maternal placental syndrome. The average age of the women in the study was 28 years.
Reporting in the Nov. 19 issue of The Lancet, the researchers compared the health outcomes of women who had placenta problems with women who didn't. "We looked at their future risk of having heart disease or stroke or blockage of one of the arteries to the legs," Ray said.
"We found that women who had placental syndromes had double the risk of developing premature cardiovascular disease, compared with women who didn't have one of those maternal placental syndromes," Ray said.
He believes that obesity before pregnancy is largely responsible for developing these syndromes. Many of the women who develop maternal placental syndromes have an abnormal metabolic state long before pregnancy, during pregnancy and after delivery, he said.
"We think that a lot of the risk for maternal placental syndromes is coming from the presence of obesity before pregnancy," Ray said. Conditions closely related to obesity, such as diabetes and high blood pressure, "create an environment that is unhealthy for the placenta and remains an unhealthy environment after the women delivers," he said.
Ray believes women can change their lifestyle and reduce their chances of maternal placental syndromes and premature heart disease.
"It isn't that hopeless," he said. "The metabolic state, to a degree, is determined by their body weight and what they eat. This study shows that there is a window for women to modify their health while they are young."
Another expert sees the study as important research into the special heart disease risks faced by women.
"We are now starting to think about things that are unique to women that can also give us clues to their risk of cardiovascular disease in the future," said Dr. Nieca Goldberg, chief of women's cardiac care at Lenox Hill Hospital, New York City and author of Women Are Not Small Men. "Before, we were looking at the traditional risk factors that predict cardiovascular disease in men."
Goldberg believes that any woman who has had a maternal placental syndrome should be watched carefully for the onset of cardiovascular disease. "Women who have had preeclampsia or other pregnancy problems shouldn't get lost to the health-care system," she said.
"We really need to make sure that we instill the advice of healthy lifestyle behavior in these young women," Goldberg said.
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
Maternal placental syndromes include preeclampsia (high blood pressure during pregnancy) and conditions where the placental blood vessels become blocked. These include placental abruption and placental infarction, where the placenta becomes detached from the wall of the uterus.
Risk factors for placental syndromes include obesity, insulin resistance, high blood pressure and high cholesterol. These same conditions are also independent risk factors for cardiovascular disease.
"We looked at more than 1 million women who delivered," said study author Dr. Joel G. Ray, an assistant professor of obstetrics and gynecology at St. Michael's Hospital of the University of Toronto. "We examined whether they experienced a problem with their placenta or not."
In the CHAMPS (Cardiovascular Health After Maternal Placental Syndromes) study, Ray and his colleagues found that of the 1.03 million women in the study, 75,380 were diagnosed with maternal placental syndrome. The average age of the women in the study was 28 years.
Reporting in the Nov. 19 issue of The Lancet, the researchers compared the health outcomes of women who had placenta problems with women who didn't. "We looked at their future risk of having heart disease or stroke or blockage of one of the arteries to the legs," Ray said.
"We found that women who had placental syndromes had double the risk of developing premature cardiovascular disease, compared with women who didn't have one of those maternal placental syndromes," Ray said.
He believes that obesity before pregnancy is largely responsible for developing these syndromes. Many of the women who develop maternal placental syndromes have an abnormal metabolic state long before pregnancy, during pregnancy and after delivery, he said.
"We think that a lot of the risk for maternal placental syndromes is coming from the presence of obesity before pregnancy," Ray said. Conditions closely related to obesity, such as diabetes and high blood pressure, "create an environment that is unhealthy for the placenta and remains an unhealthy environment after the women delivers," he said.
Ray believes women can change their lifestyle and reduce their chances of maternal placental syndromes and premature heart disease.
"It isn't that hopeless," he said. "The metabolic state, to a degree, is determined by their body weight and what they eat. This study shows that there is a window for women to modify their health while they are young."
Another expert sees the study as important research into the special heart disease risks faced by women.
"We are now starting to think about things that are unique to women that can also give us clues to their risk of cardiovascular disease in the future," said Dr. Nieca Goldberg, chief of women's cardiac care at Lenox Hill Hospital, New York City and author of Women Are Not Small Men. "Before, we were looking at the traditional risk factors that predict cardiovascular disease in men."
Goldberg believes that any woman who has had a maternal placental syndrome should be watched carefully for the onset of cardiovascular disease. "Women who have had preeclampsia or other pregnancy problems shouldn't get lost to the health-care system," she said.
"We really need to make sure that we instill the advice of healthy lifestyle behavior in these young women," Goldberg said.
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
Placenta Size May Affect Breast Cancer Risk
TUESDAY, Nov. 15 (HealthDay News) -- The heavier the placenta during pregnancy, the greater a woman's risk of breast cancer before menopause, a new Swedish study suggests.
"Compared with mothers whose placenta at first delivery weighed less than 500 grams, women whose placenta weighed equal to or greater than 700 grams had a 38 percent increase in risk of breast cancer," said study author Dr. Sven Cnattingius, a professor at the Karolinska Institute in Stockholm.
Results of the study are published in the Nov. 16 issue of the Journal of the American Medical Association.
While scientists don't know the exact cause of breast cancer, hormones clearly play a role in risk, according to Cnattingius. And during pregnancy, he added, hormone levels surge.
"Hormones during pregnancy are primarily produced by the placenta. And the levels of, for example, estriol -- the most potent estrogen -- are reported to increase with placental weight. We therefore hypothesized that a mother's risk of breast cancer may increase with placental weight," said Cnattingius.
The placenta is the temporary organ that supplies nourishment to the fetus.
To test this hypothesis, the researchers reviewed data from more than 300,000 Swedish women included in the Sweden Birth Register from 1982 through 1989. The study included follow-up information on the women through 2001, or until they had been diagnosed with breast cancer or died.
Fewer than 1 percent of the women -- 2,216 -- developed breast cancer. Almost all of the women -- 95 percent -- were diagnosed before the age of 50.
The study confirmed the researchers' hypothesis. Women whose placentas weighed 700 grams or more had a 38 percent increased risk of breast cancer, compared to women whose placentas weighed less than 500 grams, according to the study. A woman with a placenta weighing between 500 and 699 grams in one pregnancy and 700 grams or more in another pregnancy had an 82 percent increased risk of breast cancer, compared to women who had two pregnancies with placentas weighing less than 500 grams.
When compared to women with two pregnancies with placentas weighing under 500 grams, women whose placentas weighed 700 grams or more in two pregnancies had double the risk of breast cancer, the researchers said.
"The risk of (predominantly premenopausal) breast cancer among mothers increase with placental weight," Cnattingius concluded.
The researchers also confirmed previous findings that an earlier maternal age was somewhat protective against breast cancer. Those whose first pregnancies occurred when they were 19 or younger had about a 10 percent reduced risk of breast cancer, while those who waited until they were 35 or older to have their first child faced 20 times the average breast cancer risk.
Commenting on the placenta findings, Debbie Saslow, director of breast and gynecological cancer control for the ACS, said, "This is an interesting study, but it's not cause-and-effect, it's an association. The risk reported is a really small relative risk, and it's not going to change any lifestyle recommendations."
The only women who might want to consider these findings are those who have tested positive for breast cancer genes, Saslow added.
If you know you're already at a high risk for breast cancer, and if you don't feel strongly about when in your life you have children, it might be better to have them earlier, she said. But, that doesn't mean you couldn't have children later in life either, she added.
What women can do to help prevent breast cancer is get enough exercise, eat right and don't drink alcohol excessively. Besides potentially lowering your breast cancer risk, you'll also lower your risk of heart disease and diabetes by taking these steps, she said.
More than 200,000 American women are diagnosed with breast cancer each year, according to the ACS. Over a lifetime, 13 percent of U.S. women will develop the disease, according to the society.
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
"Compared with mothers whose placenta at first delivery weighed less than 500 grams, women whose placenta weighed equal to or greater than 700 grams had a 38 percent increase in risk of breast cancer," said study author Dr. Sven Cnattingius, a professor at the Karolinska Institute in Stockholm.
Results of the study are published in the Nov. 16 issue of the Journal of the American Medical Association.
While scientists don't know the exact cause of breast cancer, hormones clearly play a role in risk, according to Cnattingius. And during pregnancy, he added, hormone levels surge.
"Hormones during pregnancy are primarily produced by the placenta. And the levels of, for example, estriol -- the most potent estrogen -- are reported to increase with placental weight. We therefore hypothesized that a mother's risk of breast cancer may increase with placental weight," said Cnattingius.
The placenta is the temporary organ that supplies nourishment to the fetus.
To test this hypothesis, the researchers reviewed data from more than 300,000 Swedish women included in the Sweden Birth Register from 1982 through 1989. The study included follow-up information on the women through 2001, or until they had been diagnosed with breast cancer or died.
Fewer than 1 percent of the women -- 2,216 -- developed breast cancer. Almost all of the women -- 95 percent -- were diagnosed before the age of 50.
The study confirmed the researchers' hypothesis. Women whose placentas weighed 700 grams or more had a 38 percent increased risk of breast cancer, compared to women whose placentas weighed less than 500 grams, according to the study. A woman with a placenta weighing between 500 and 699 grams in one pregnancy and 700 grams or more in another pregnancy had an 82 percent increased risk of breast cancer, compared to women who had two pregnancies with placentas weighing less than 500 grams.
When compared to women with two pregnancies with placentas weighing under 500 grams, women whose placentas weighed 700 grams or more in two pregnancies had double the risk of breast cancer, the researchers said.
"The risk of (predominantly premenopausal) breast cancer among mothers increase with placental weight," Cnattingius concluded.
The researchers also confirmed previous findings that an earlier maternal age was somewhat protective against breast cancer. Those whose first pregnancies occurred when they were 19 or younger had about a 10 percent reduced risk of breast cancer, while those who waited until they were 35 or older to have their first child faced 20 times the average breast cancer risk.
Commenting on the placenta findings, Debbie Saslow, director of breast and gynecological cancer control for the ACS, said, "This is an interesting study, but it's not cause-and-effect, it's an association. The risk reported is a really small relative risk, and it's not going to change any lifestyle recommendations."
The only women who might want to consider these findings are those who have tested positive for breast cancer genes, Saslow added.
If you know you're already at a high risk for breast cancer, and if you don't feel strongly about when in your life you have children, it might be better to have them earlier, she said. But, that doesn't mean you couldn't have children later in life either, she added.
What women can do to help prevent breast cancer is get enough exercise, eat right and don't drink alcohol excessively. Besides potentially lowering your breast cancer risk, you'll also lower your risk of heart disease and diabetes by taking these steps, she said.
More than 200,000 American women are diagnosed with breast cancer each year, according to the ACS. Over a lifetime, 13 percent of U.S. women will develop the disease, according to the society.
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
U.S. Preemie Births, Caesareans Reach Record Highs
U.S. Preemie Births, Caesareans Reach Record Highs
Fear of lawsuits may be driving surge in C-sections, experts say
TUESDAY, Nov. 15 (HealthDay News) -- The number of premature births in the United States and the rate of Caesarean delivery are the highest they've ever been, according to new government figures released Tuesday.
The report, by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics, showed that the C-section delivery rate rose to 29.1 percent in 2004, an increase of more than 40 percent since 1996. And more than half a million babies were born preterm last year, the highest number ever recorded.
"Measures of maternal and infant health are not improving in the country," said lead author Joyce A. Martin, lead statistician at the reproductive statistics branch of the National Center for Health Statistics in Hyattsville, Md.
"We don't have a good sense of why that is, quite frankly," she added.
"Preterm births increased for the first time in at least two decades to more than 500,000 births in 2004," Martin said. "The rate increased 2 percent between 2003 and 2004, and has risen more than 18 percent since 1990."
One factor responsible for the dramatic increase in preterm birth rates is the increase in multiple births, Martin said.
"Multiple births are much more likely to be born too early and too small," she said. "But there is also an increase in single preterm deliveries, and the reasons for that are less clear."
Martian noted that low birth weight has followed a similar path. The low birth weight rate increased from 7.9 percent in 2003 to 8.1 percent in 2004. Since 1990, the percentage of infants born with low birth weight has risen 16 percent, according to the report.
In addition, the rate of C-section deliveries rose 6 percent in 2004 to 29.1 percent of all births, the highest rate ever reported in the United States. "It's up 40 percent since 1996," Martin said. "It had declined in the 80s until 1996, and there has been a strong upswing since."
Other findings in the report, which includes data from birth certificates processed through May 2005, include a slight decrease in tobacco use among pregnant women and no change in the number of women seeking prenatal care.
One expert sees several factors as responsible for these trends.
"The increase in the Caesarean births is due to three things -- malpractice, malpractice, malpractice," said Dr. Joshua A. Copel, director of Maternal and Fetal Medicine at Yale University School of Medicine.
Copel believes that the decision to do cesarean deliveries is largely based on doctors' fear of litigation. "Not that much has changed about the American population to account for such an increase in Caesarean birth rates except the fear of obstetricians of being sued," he said.
In terms of the increase in premature delivery, the reasons for the increase are not clear, Copel said. "I would speculate that you would find an interaction between multiple birth and premature delivery and obesity," he said. "Women who have higher body mass have higher insulin resistance, and are more likely to ovulate infrequently and take medication to ovulate more frequently."
Copel also noted that birth certificate data are spotty. "They must be taken with some skepticism," he said. "The only things you can rely on in birth certificates are date of birth, the gender and the weight."
Another expert blames current priorities in U.S. medical care.
That preterm and low birth weight babies were more common in 2004 than in the years preceding reflects a widening of health-care disparities, as these outcomes are more common among ethnic minorities, said Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine. "Efforts to address such disparities have apparently failed, as the timely delivery of prenatal care was no higher in 2004 than in previous years," he said.
"Most disturbing are data showing a steady increase in the rate of Caesarean delivery," Katz added. "While the so-called C-section can be invaluable when used to address complications of labor and delivery, it appears to be used increasingly for mere convenience, or to avoid liability associated with the natural risks of birthing."
"That we are doing more surgery, but not delivering more prenatal care, is quite concerning," Katz said. "Pregnancy-related care should be a national priority, and delivery a matter of Nature's timing, not the obstetrician's convenience. The trends in this report call for a reassessment of our priorities."
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
Fear of lawsuits may be driving surge in C-sections, experts say
TUESDAY, Nov. 15 (HealthDay News) -- The number of premature births in the United States and the rate of Caesarean delivery are the highest they've ever been, according to new government figures released Tuesday.
The report, by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics, showed that the C-section delivery rate rose to 29.1 percent in 2004, an increase of more than 40 percent since 1996. And more than half a million babies were born preterm last year, the highest number ever recorded.
"Measures of maternal and infant health are not improving in the country," said lead author Joyce A. Martin, lead statistician at the reproductive statistics branch of the National Center for Health Statistics in Hyattsville, Md.
"We don't have a good sense of why that is, quite frankly," she added.
"Preterm births increased for the first time in at least two decades to more than 500,000 births in 2004," Martin said. "The rate increased 2 percent between 2003 and 2004, and has risen more than 18 percent since 1990."
One factor responsible for the dramatic increase in preterm birth rates is the increase in multiple births, Martin said.
"Multiple births are much more likely to be born too early and too small," she said. "But there is also an increase in single preterm deliveries, and the reasons for that are less clear."
Martian noted that low birth weight has followed a similar path. The low birth weight rate increased from 7.9 percent in 2003 to 8.1 percent in 2004. Since 1990, the percentage of infants born with low birth weight has risen 16 percent, according to the report.
In addition, the rate of C-section deliveries rose 6 percent in 2004 to 29.1 percent of all births, the highest rate ever reported in the United States. "It's up 40 percent since 1996," Martin said. "It had declined in the 80s until 1996, and there has been a strong upswing since."
Other findings in the report, which includes data from birth certificates processed through May 2005, include a slight decrease in tobacco use among pregnant women and no change in the number of women seeking prenatal care.
One expert sees several factors as responsible for these trends.
"The increase in the Caesarean births is due to three things -- malpractice, malpractice, malpractice," said Dr. Joshua A. Copel, director of Maternal and Fetal Medicine at Yale University School of Medicine.
Copel believes that the decision to do cesarean deliveries is largely based on doctors' fear of litigation. "Not that much has changed about the American population to account for such an increase in Caesarean birth rates except the fear of obstetricians of being sued," he said.
In terms of the increase in premature delivery, the reasons for the increase are not clear, Copel said. "I would speculate that you would find an interaction between multiple birth and premature delivery and obesity," he said. "Women who have higher body mass have higher insulin resistance, and are more likely to ovulate infrequently and take medication to ovulate more frequently."
Copel also noted that birth certificate data are spotty. "They must be taken with some skepticism," he said. "The only things you can rely on in birth certificates are date of birth, the gender and the weight."
Another expert blames current priorities in U.S. medical care.
That preterm and low birth weight babies were more common in 2004 than in the years preceding reflects a widening of health-care disparities, as these outcomes are more common among ethnic minorities, said Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine. "Efforts to address such disparities have apparently failed, as the timely delivery of prenatal care was no higher in 2004 than in previous years," he said.
"Most disturbing are data showing a steady increase in the rate of Caesarean delivery," Katz added. "While the so-called C-section can be invaluable when used to address complications of labor and delivery, it appears to be used increasingly for mere convenience, or to avoid liability associated with the natural risks of birthing."
"That we are doing more surgery, but not delivering more prenatal care, is quite concerning," Katz said. "Pregnancy-related care should be a national priority, and delivery a matter of Nature's timing, not the obstetrician's convenience. The trends in this report call for a reassessment of our priorities."
Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!
Lupus, Rheumatoid Arthritis Raise Pregnancy Risks
TUESDAY, Nov. 15 (HealthDay News) -- Pregnant women with lupus or rheumatoid arthritis may experience more pregnancy complications and longer hospitalizations than other women, a new study finds.
Stanford University researchers analyzed 2002 data from the Nationwide Inpatient Sample, which contains discharge records from representative U.S. hospitals. The researchers compared delivery outcomes and hospitalizations for nearly 3,300 women with lupus and more than 1,400 women with rheumatoid arthritis to women in the general population.
Reporting at this week's annual scientific meeting of the American College of Rheumatology in San Diego, they found that women with lupus had twice the rate of hypertensive disorders, compared to women with rheumatoid arthritis. Women with either lupus or rheumatoid arthritis had higher rates of hypertensive disorders than pregnant women in the general population.
Women with lupus or rheumatoid arthritis also faced higher rates of intrauterine growth restrictions and Cesarean delivery, the study said.
"Women with either lupus and/or rheumatoid arthritis are typically somewhat older when they become pregnant," researcher Dr. Eliza F. Chakravarty, assistant professor of medicine with Stanford's division of immunology and rheumatology, noted in a prepared statement.
"However, even after adjusting for maternal age, they run a higher risk for adverse outcomes and generally experience longer hospital stays than other women. As a result, they should be monitored carefully for the length of their pregnancies," Chakravarty said.
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Stanford University researchers analyzed 2002 data from the Nationwide Inpatient Sample, which contains discharge records from representative U.S. hospitals. The researchers compared delivery outcomes and hospitalizations for nearly 3,300 women with lupus and more than 1,400 women with rheumatoid arthritis to women in the general population.
Reporting at this week's annual scientific meeting of the American College of Rheumatology in San Diego, they found that women with lupus had twice the rate of hypertensive disorders, compared to women with rheumatoid arthritis. Women with either lupus or rheumatoid arthritis had higher rates of hypertensive disorders than pregnant women in the general population.
Women with lupus or rheumatoid arthritis also faced higher rates of intrauterine growth restrictions and Cesarean delivery, the study said.
"Women with either lupus and/or rheumatoid arthritis are typically somewhat older when they become pregnant," researcher Dr. Eliza F. Chakravarty, assistant professor of medicine with Stanford's division of immunology and rheumatology, noted in a prepared statement.
"However, even after adjusting for maternal age, they run a higher risk for adverse outcomes and generally experience longer hospital stays than other women. As a result, they should be monitored carefully for the length of their pregnancies," Chakravarty said.
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Friday, November 11, 2005
Gene May Spur ADHD Antisocial Behaviors
Gene May Spur ADHD Antisocial Behaviors
Mutation might also be tied to problems stemming from low birth weight, researchers say
WEDNESDAY, Nov. 9 (HealthDay News) -- Antisocial behavior in children with attention deficit hyperactivity disorder (ADHD) may be associated with a variant gene involved in brain signaling, British researchers report.
This variant of the "catechol O-methyltransferase" (COMT) gene may also increase a child's susceptibility to the effects of lower birth weight, the study said.
Researchers at Cardiff University in Wales looked for the COMT variant in 240 children, ages 5 to 14, with ADHD who were at high risk for early onset antisocial behavior.
The study found a significant association between the COMT variant and antisocial behavior and between birth weight and antisocial behavior.
The researchers also concluded that interaction between this COMT variant and low birth weight could be associated with antisocial behavior.
"Early onset antisocial behavior in a high-risk clinical group was predicted by a specific COMT gene variant previously linked with prefrontal cortical [brain] function and birth weight," the study authors concluded.
The findings appear in the November issue of the journal Archives of General Psychiatry.
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Test Detects Down Syndrome Early
WEDNESDAY, Nov. 8 (HealthDay News) -- Researchers say that by using a test called first-trimester combined screening, they can now detect Down syndrome earlier in pregnancy than ever before.
The combined screen includes an ultrasound test called a nuchal translucency test, plus tests that look for two proteins in maternal blood.
"This test is a big step forward for pregnant women because, on its own, it picks up 87 percent of cases of Down syndrome, and does so extremely early in pregnancy -- 11 or 12 weeks -- which is sufficiently early that women can find out important pregnancy information before being visibly pregnant," said Dr. Fergal Malone, chairman of the department of Obstetrics and Gynecology at the Royal College of Surgeons in Dublin, Ireland.
Malone was lead author of the study, which compared the new test to standard second-trimester screening, called quadruple screening. His team published their findings in the Nov. 10 issue of the New England Journal of Medicine.
According to the March of Dimes, the average 25-year-old American woman has about a one-in-1,250 chance of giving birth to a baby with Down syndrome. That risk climbs with age, so that by the time a woman reaches 40, her odds of giving birth to a Down baby has risen to about one in 100.
Second-trimester quadruple screening is currently the standard Down syndrome screening test used in the United States, according to the study. This test, which focuses on maternal blood proteins, is generally performed 15 weeks to pregnancy. If test results are abnormal, many women choose to undergo amniocentesis, which can diagnose Down syndrome. This means that a woman is often 18 or 19 weeks pregnant when she gets her amniocentesis results, Malone said.
He said the nuchal translucency test was first developed in the early 1990s and can only be done at between 11 and 13 weeks' gestation. Using ultrasound, a technician measures the thickness of the back of the fetus' neck. A difference of just a fraction of a millimeter, along with the presence of two proteins -- pregnancy-associated plasma protein A and the free beta subunit of human chorionic gonadatropin -- can signal the presence of Down syndrome.
If this combined screening test is positive, many women follow-up with chorionic villus sampling (CVS), which like amniocentesis can diagnose Down syndrome, but does so at an earlier stage of pregnancy. The optimal time for this test is 11 weeks. Before then, the fetus is too small, and after 13 weeks, the fetus is too large for the ultrasonographer to get an accurate picture.
To compare combined screening to standard quadruple screening, Malone and colleagues from centers in the United States, Ireland and the U.K. performed both tests on more than 38,000 pregnant women. One hundred and seventeen women in this group had babies with Down syndrome.
Both tests had an overall 5 percent false-positive rate, meaning that they picked up "cases" of abnormality that were in fact normal. The first-trimester combined screening was more effective in detecting Down syndrome, the researchers report.
Rates of detection for combined screening were 87 percent, 85 percent and 82 percent for tests done at 11, 12 and 13 weeks, respectively. Traditional quadruple screening had a detection rate of 81 percent.
The researchers stressed that the nuchal translucency test is very difficult to perform, and requires special training.
"Typical measurements in most women are only about 1 millimeter, and fractions of a millimeter differences in this measurement can make a huge difference to the risk of Down syndrome quoted to the woman," said Malone, who added that even the best-trained sonographers can't obtain measurements in 7 percent to 8 percent of cases.
Still, Malone said he is offering combined screening to his patients.
"The major benefit is that women can now get a great degree of reassurance about the health of their baby, and the likelihood that they are going to have a normal pregnancy, much earlier than previously. Additionally, if bad news is discovered, and a patient decides to undergo a pregnancy termination, such terminations are much safer for the woman at 12 weeks compared with 20 weeks," said Malone.
"This study confirms that first-trimester combined screening is a very precise way to screen for Down," said Dr. Allen Hogge, chairman of the department of obstetrics and gynecology and a geneticist at Magee-Women's Hospital at the University of Pittsburgh Medical Center.
"The problem at this point is that it's not going to be widely available for a while," he said. "It's also just a screening test. It's not a yes or no answer."
Malone added that while the combined screening test isn't widely available, it is being performed in many major medical centers in the United States and Europe. However, he pointed out that many insurers, including Medicaid, aren't currently reimbursing for this test yet.
"Patients may have to pay for this screening test themselves, or they and their doctors may have to get involved with complex claims procedures. Hopefully, the data provided in [our] trial will convince more insurers that not only is this a valid test, but it is probably the single most efficient screening test for Down syndrome that is available today," said Malone.
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Health Tip: Risk Factors for Miscarriage
FRIDAY Nov. 11 (HealthDay News) -- Up to one in five pregnancies ends in miscarriage, a devastating result for the prospective parents and their families.
Here are some risk factors for miscarriage, courtesy of the Baystate Health system of New England:
- Infection.
- Hormonal imbalance.
- Exposure to lead or radiation.
- Drinking, drugs and smoking.
- Sexually transmitted diseases.
- Diabetes.
- Poor nutrition.
The first signs of miscarriage often are vaginal bleeding and cramping. If you're pregnant and have either of these symptoms, talk to your doctor immediately.
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Monday, October 31, 2005
Health Tip: Pregnancy Test Kit Must Be Used Correctly
Health Tip: Pregnancy Test Kit Must Be Used Correctly
Or you may skew the result
(HealthDay News) -- Home pregnancy tests are fairly reliable, but their accuracy can be compromised if not used correctly, the Mayo Clinic says.
Possible causes of a false-positive result may be using an unclean urine collection cup, using an old or damaged kit, having an impure urine sample because of blood or excessive protein, and taking prescription drugs such as diuretics and anticonvulsants.
False-negative results may stem from taking the test too early, timing the test incorrectly, and using diluted urine.
If the results of a home pregnancy test are questionable, read the directions, call the toll-free number usually located on the test box, or take the test a second time.
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Friday, October 14, 2005
Maternal Blood Test Might Reveal Fetal Health
Maternal Blood Test Might Reveal Fetal Health
Early research points the way to safe, accurate prenatal screen
FRIDAY, Oct. 7 (HealthDay News) -- New research is moving scientists closer to the holy grail of prenatal medical care: a maternal blood test that could reveal health problems in an unborn child.
Researchers from Hong Kong reported this week that they've discovered a potential new way to differentiate the DNA of the mother from that of the fetus in a maternal blood plasma sample. The key, they say, lies in a DNA trait that's much more common in maternal genetic material.
Specialists couldn't predict how long it may take for the findings to translate into a routine fetal DNA screening test available in the doctor's office. And the study results don't appear to have any bearing, at least for now, on controversial fetal DNA tests that promise to predict a baby's gender early in pregnancy.
Still, the research is promising, said Dr. Siobhan Dolan, associate medical director at the March of Dimes. "This study is a step in the right direction," she noted.
Currently, the best screening tests for fetal medical problems -- including amniocentesis -- are also potentially dangerous to the unborn child. Doctors and researchers have been looking for a noninvasive test, and a test using the mother's blood would certainly fit the bill (current blood tests for pregnant mothers don't directly measure the health status of the fetus).
The good news is that a small bit of fetal blood does blend in with the mother's blood. "The trick is to find a way to sort out in the blood what came from the fetus and what came from the mother," Dolan said.
Only about 3 percent of DNA in maternal blood plasma comes from the fetus, said study author Dennis Lo, a professor of chemical pathology at the Chinese University of Hong Kong. There are ways to differentiate the fetal DNA, such as looking for the male Y chromosome, he said, but that only works for male fetuses.
In the new study, Lo and his colleagues report that they can differentiate maternal from fetal DNA by looking for a specific gene that acts differently in mothers and fetuses. They also used their technique to accurately detect cases of pregnancy-associated hypertension, also known as preeclampsia, in pregnant women.
The findings appear in this week's early online edition of the Proceedings of the National Academy Sciences.
Earlier this year, researchers reported that they were able to more easily analyze fetal DNA by boosting its levels in blood samples. Scientists have also found a way to separate bits of maternal and fetal DNA by analyzing their size.
The new research may have implications for existing fetal DNA tests, such as those that detect potentially dangerous blood group incompatibilities between mother and fetus, Lo said. It's not yet known if the tests will help pick up other diseases like Down syndrome, but researchers are hopeful, Lo said.
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New Insights into Preemie Infant Brain Injury
New Insights into Preemie Infant Brain Injury
Neurological damage once considered harmless may not be, study suggests
MONDAY, Oct. 3 (HealthDay News) -- A part of the brain called the cerebellum -- previously believed to be principally involved in motor coordination -- also plays an important role in the development of behavior and cognition, new research reveals.
Experts at Children's Hospital Boston used MRI to study the brains of 47 premature babies. Cerebellar injury is increasingly recognized as a potentially serious complication of premature birth.
Reporting in the October issue of Pediatrics, they found that cerebellar injury can have a major impact on development, and that the cerebellum and another part of the brain, the cerebrum, are tightly interconnected. It's long been believed that the cerebrum is the primary location of higher cognitive functions such as language and visual processing.
The Boston team found that when the cerebrum was injured, the cerebellum failed to grow to a normal size. And when the cerebellar injury was limited to one side, the opposite cerebral hemisphere did not grow to normal size.
"There seems to be an important developmental link between the cerebrum and the cerebellum. We're finding that the two structures modulate each other's growth and development. The way the brain forms connections between structures may be as important as the injury itself," study author and neurologist Catherine Limperopoulos said in a prepared statement.
"Until recently, cerebellar injury was underrecognized. Doctors downplayed it, saying 'Oh, maybe Johnny will be a little clumsy,'" she said. "Our research has made us aware that cerebellar injury is not a benign finding. We now know to look for it, and can counsel families that their children are likely to have deficits that extend beyond motor, and that may benefit from early intervention."
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Vaccine Might Shield Newborns from Infection
Vaccine Might Shield Newborns from Infection
Study will examine whether vaginal bacteria can be suppressed during childbirth
THURSDAY, Sept. 29 (HealthDay News) -- U.S. researchers are conducting a study to determine if a new vaccine can protect newborn babies from potentially lethal infection.
The infection is caused by common bacteria called group B strep that live harmlessly in the gastrointestinal tract and vagina of 25 percent of women. Exposure to these bacteria during birth can trigger potentially lethal infections in newborns, however.
"If we could give a vaccine to prevent women from harboring group B streptococcus in the vagina, then babies are not going to get it," Dr. Daron Ferris, a family medicine physician at the Medical College of Georgia and principal investigator of the U.S. National Institutes of Health study, explained in a prepared statement.
The 18-month study of 600 healthy, non-pregnant women will compare the effectiveness of the vaccine -- which was developed at Harvard University -- with a standard tetanus toxoid vaccine in controlling group B infections in the study participants.
Group B strep is the most common infectious cause of death in newborn babies, according to the U.S. Centers for Disease Control and Prevention. Infection-related problems typically occur in the first week of life when a baby's immune system is immature and unable to fight off infection. The bacteria can cause septicemia, meningitis, pneumonia and long-term hearing and vision damage in infants, as well as developmental problems.
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Immune Drug May Prevent Fetal Infection
Immune Drug May Prevent Fetal Infection
Hyperimmune globulin cut rate of mom-to-child transmission of cytomegalovirus
THURSDAY, Sept. 29 (HealthDay News) -- A drug that boosts a woman's immune system during pregnancy may help prevent her from passing along a common but dangerous virus to her unborn baby, Italian researchers report.
The drug, called hyperimmune globulin, cut rates of mother-to-child transmission of cytomegalovirus (CMV) to just 3 percent of babies born to women infected with the virus.
In contrast, 50 percent of infected mothers who did not receive the treatment passed on the potentially harmful pathogen to their newborn.
"Hyperimmune globulin was effective in treating and preventing mothers from transmitting the infection," said study co-author Dr. Stuart Adler, a professor of pediatrics and chairman of infectious disease at the Medical College of Virginia Campus of Virginia Commonwealth University in Richmond.
His team published their findings in the Sept. 29 issue of the New England Journal of Medicine.
Cytomegalovirus is a very common infection that is usually harmless for adults and children, according to experts at the March of Dimes. About half of the U.S. population will have contracted CMV by the time they're 30.
But the virus can cause grave harm to newborns. About 1 percent of all babies born in the United States are born with congenital cytomegalovirus, an infection that varies in severity from causing no symptoms to causing severe neurological problems and even death.
There's currently no effective treatment for the infection, and if a mother is infected with the virus during pregnancy, there's about a 40 percent chance that she'll pass the infection on to her offspring.
Hyperimmune globulin is a type of immunotherapy designed to boost the maternal immune system. For the current study, CMV-specific hyperimmune globulin was used to ramp up the immune system against this particular threat.
Adler said the researchers suspected the CMV-specific hyperimmune globulin would work in humans because of prior research in human cell cultures and animals. The therapy is considered very safe, and no adverse effects have been noted.
Because the therapy is considered so safe for women and the consequences of an active CMV infection can be so severe for newborns, the study was not randomized and women were offered the option to receive treatment.
Pregnant women were recruited for the study from eight Italian cities. Women with active CMV infection were then separated into either a therapy group or a prevention group.
The therapy group included 45 women who had an active CMV infection, as did their babies. All babies were tested via amniocentesis. Thirty-one of these women elected to receive treatment with hyperimmune globulin, and 14 chose not to receive the therapy.
Only one woman (3 percent) in the therapy group gave birth to an infant with CMV disease, defined as a displaying symptoms of infection at birth and being in some way handicapped at 2 years or older.
In contrast, seven women (50 percent) of the women who weren't treated gave birth to babies with CMV disease.
The "prevention" group included 84 women with CMV infection who chose not to undergo amniocentesis, so the researchers didn't know whether or not these babies were infected. Thirty-seven of these women chose to receive hyperimmune globulin, compared to 47 women who declined.
Six out of the 37 women (16 percent) who received treatment delivered babies with congenital CMV vs. 19 out of 47 women (40 percent) who did not receive the treatment.
"This new therapy is very exciting because there has been no effective therapy for protecting babies from CMV," said Dr. Patrick Duff, from the University of Florida College of Medicine in Gainesville, and author of an accompanying editorial.
However, Duff added, "There's still room for caution here. This study didn't include a huge number of patients, and it wasn't randomized." He also noted that screening tests for CMV aren't 100 percent accurate and therapy with hyperimmune globulin is expensive. "There are still some loose ends," he said.
Both Adler and Duff said additional studies need to be done to confirm these findings.
In the meantime, Adler believes women who are pregnant or thinking of becoming pregnant should be screened for CMV -- especially if they are at high risk for infection. High-risk groups include women who spend a lot of time with young children, such as a teacher or day-care worker or a mother of a young child under the age of 2 or 3, he said.
Women who test seronegative -- meaning they've never had the disease -- need to take precautions to lessen the chance of getting infected with CMV while they are pregnant. This means frequent and thorough hand washing and avoiding intimate contact with youngsters -- no kissing on the lips or sharing eating utensils. Women who test seropositive -- meaning they've had the infection at some point in the past -- are at extremely low risk of passing any active infection onto their baby, however.
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Fewer Women Taking Folic Acid Supplements
Fewer Women Taking Folic Acid Supplements
The B vitamin helps prevent birth defects, researchers say
THURSDAY, Sept. 29 (HealthDay News) -- The number of American women taking folic acid supplements to prevent serious birth defects of the brain and spine decreased from 40 percent in 2004 to 33 percent this year, according to a new report from the March of Dimes.
The report appears in the Sept. 30 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
"We have found that over the years the percentage of women reporting taking a vitamin containing folic acid every day has gone back down to 33 percent in 2005," said report co-author Heather Carter, a CDC nutrition epidemiologist.
The researchers also found that the percentage of women who were aware of folic acid increased from 78 percent in 2004 to 84 percent in 2005.
While awareness increased, the percentage of women who know that folic acid prevents birth defects remained unchanged at 25 percent. And the percentage of women who know that folic acid should be taken before pregnancy dropped from 12 percent in 2004 to just 7 percent in 2005, the lowest percentage since 1997, according to the survey.
There are number of reasons why women don't take folic acid supplements, Carter noted. "The most common reason for not taking a vitamin is forgetting to take it," she said. "Twenty-eight percent say they forget to take a vitamin."
Many women also think they don't need to take a vitamin, Carter said. "Some women also believe that they can get the vitamin from the food they eat," she said. "We need to motivate women to take either a vitamin supplement or get folic acid from fortified foods."
Women of childbearing age are advised to take folic acid, a B vitamin, every day. Folic acid can also come from vitamin pills or foods such as enriched breads and cereals, leafy green vegetables and citrus fruits.
"Every women of childbearing age needs to be consuming a vitamin containing 400 micrograms of folic acid every day to try to prevent serious birth defects of the brain and spine," Carter stressed.
These birth defects most often include the neural tube defects spina bifida and anencephaly (incomplete brain formation). These birth defects, occurring in an estimated 3,000 pregnancies in the United States each year, can cause lifelong disability or death, according to the CDC.
One expert agrees with the importance of getting enough folic acid, and thinks that women can get the folic acid they need by eating vitamin-enriched foods.
The difficulty in getting all women of childbearing age to get enough folic acid owes to a combination of education and economics, said Tsunenobu Tamura, a professor of nutrition science at the University of Alabama.
"However, if women are eating enriched grain products like bread and cereal, they should get folic acid in addition to the folic acid they are getting from regular food," Tamura said.
Tamura encourages women to get folic acid from foods. "If you go to the grocery story you should select items that contain enriched flour to get folic acid," he said. "If women get folic acid through enriched foods, they may not need to take folic acid supplementation."
But another expert thinks that taking a supplement is the best way to guarantee that women are getting enough folic acid.
"To ensure that women get 400 micrograms of folic acid daily, the most assured way is though a multivitamin supplement," said report co-author Joanne Petrini, director of the perinatal data center at the March of Dimes Birth Defects Foundation.
There are probably not a lot of women getting the required amount of folic acid through diet, Petrini said. "Only a third are getting it through supplements, which means that 70 percent don't," she added.
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